[Diabetes mellitus: complications associated with time since diagnosis, health insurance, use of health services, and medication use, Brazilian National Health Survey 2019].

This study aimed to estimate the occurrence of diabetes mellitus complications in adults and their association with the time since diagnosis, health insurance coverage, use of health services, and medication use. This is a population-based cross-sectional study using data from the 2019 Brazilian National Health Survey (PNS). Individuals aged ≥ 40 years (n = 54,987) were considered, and the prevalence of diabetes and its complications, as well as medication use, was estimated. Associations between the occurrence of the selected complications and the time since diabetes diagnosis, health insurance coverage, and health service use were examined using both crude and adjusted prevalence ratios, employing Poisson regression with robust variance. The prevalence of diabetes in the study population was 13.4% (95%CI: 12.9-13.9), and that of complications was 31% (95%CI: 29.2-32.9). The most prevalent complications were vision problems (29.6%; 95%CI: 27.6-31.6) and kidney problems (9.2%; 95%CI: 8.2-10.4). The prevalence of all complications increased with the time since diagnosis (p < 0.05). The prevalence of vision problems was higher among individuals without health insurance (32.7% vs. 21.5%; p < 0.001) and among those who had seen a doctor in the last six months (31.1% vs. 25.2%; p = 0.007) compared to those whose last visit was between six months and less than three years. Medication use among those with complications was 93.3% (95%CI: 91.5-94.8); however, more than 1.5 million people in this group were not using their prescribed medications. Strengthening actions by the Brazilian Unified National Health System (SUS) are necessary, particularly screening exams for the early identification of diabetes mellitus and its complications.